Battista R N, Hodge M J
Department of Epidemiology and Biostatistics, McGill University, Montreal QC.
CMAJ. 1995 Nov 1;153(9):1233-7.
Setting priorities and selecting topics are important steps in guidelines development, but they have received relatively little attention to date. Responses from a survey of guidelines stakeholders in Canada suggest that the health burden of a clinical condition on the population is an important factor in priority setting. Economic considerations, cast as either costs of treatment to the health care system or the economic burden of illness to society, are given varying importance by different stakeholder groups. Drawing on the literature and the survey results, the authors propose a framework for priority setting. Important issues requiring consideration include the role of public and community participation, the need for and appropriate emphasis on quantitative data regarding current practice and its variation, and mechanisms to link guidelines to health-policy development and management of the health care system.
确定优先事项和选择主题是制定指南过程中的重要步骤，但迄今为止它们受到的关注相对较少。加拿大对指南利益相关者的一项调查结果表明，临床病症对人群的健康负担是确定优先事项的一个重要因素。经济因素，无论是对医疗保健系统的治疗成本还是疾病对社会的经济负担，不同利益相关者群体对其重视程度各不相同。作者借鉴文献和调查结果，提出了一个确定优先事项的框架。需要考虑的重要问题包括公众和社区参与的作用、对当前实践及其差异的定量数据的需求和适当强调，以及将指南与卫生政策制定和医疗保健系统管理相联系的机制。
